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General NPI Number Information
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NPI Number | 1386138873
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Entity Type | Organization
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Legal Business Name | PCR DIAGNOSTICS LLC
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Dates
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Enumeration Date | 06/18/2018
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Last Update Date | 12/10/2020
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Provider Practice Location Address
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Address Line | 1201 S MAIN ST STE 117
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City | BOERNE
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State | TX
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Zip | 78006-2839
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Country | US
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Telephone | 210-463-9196
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Fax | 833-756-1638
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Provider Business Mailing Address
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Address Line | 1201 S MAIN ST STE 117
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City | BOERNE
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State | TX
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Zip | 78006-2839
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Country | US
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Telephone | 210-463-9196
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Fax | 833-756-1638
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Authorized Official
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Title or Position | DIRECTOR
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Name | LORELEI PARKER
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Credential |
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Telephone | 210-463-9196
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State | TX
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